Disease contact tracing in random and clustered networks

The efficacy of contact tracing, be it between individuals (e.g. sexually transmitted diseases or severe acute respiratory syndrome) or between groups of individuals (e.g. foot-and-mouth disease; FMD), is difficult to evaluate without precise knowledge of the underlying contact structure; i.e. who is connected to whom? Motivated by the 2001 FMD epidemic in the UK, we determine, using stochastic simulations and deterministic 'moment closure' models of disease transmission on networks of premises (nodes), network and disease properties that are important for contact tracing efficiency. For random networks with a high average number of connections per node, little clustering of connections and short latency periods, contact tracing is typically ineffective. In this case, isolation of infected nodes is the dominant factor in determining disease epidemic size and duration. If the latency period is longer and the average number of connections per node small, or if the network is spatially clustered, then the contact tracing performs better and an overall reduction in the proportion of nodes that are removed during an epidemic is observed.     

A stochastic model for extinction and recurrence of epidemics: estimation and inference for measles outbreaks

Epidemic dynamics pose a great challenge to stochastic modelling because chance events are major determinants of the size and the timing of the outbreak. Reintroduction of the disease through contact with infected individuals from other areas is an important latent stochastic variable. In this study we model these stochastic processes to explain extinction and recurrence of epidemics observed in measles. We develop estimating functions for such a model and apply the methodology to temporal case counts of measles in 60 cities in England and Wales. In order to estimate the unobserved spatial contact process we suggest a method based on stochastic simulation and marginal densities. The estimation results show that it is possible to consider a unified model for the UK cities where the parameters depend on the city size. Stochastic realizations from the dynamic model realistically capture the transitions from an endemic cyclic pattern in large populations to irregular epidemic outbreaks in small human host populations.     

A computer exploration of some properties of non-linear stochastic partnership models for sexually transmitted diseases with stages

In this paper, branching process approximations to non-linear stochastic partnership models for sexually transmitted diseases in heterosexual populations were used to find points in the parameter space such that an epidemic would occur. At selected points in the parameter space, samples of Monte Carlo realizations of the process were computed and analyzed statistically to gain insights into the stochastic evolution of epidemics seeded by one infective single female and male. Non-linear difference equations were embedded in the stochastic processes, making it possible to compare trajectories computed according to the deterministic model with those computed from samples of Monte Carlo realizations. From these trajectories it was shown that stochastic fluctuations may have a profound effect on the long-term evolution of an epidemic, and examples demonstrate that an investigator may be misled if a deterministic model alone were used to project an epidemic, particularly when there is a significant probability of extinction.     

Modeling the impact of random screening and contact tracing in reducing the spread of HIV

Mathematical models can help predict the effectiveness of control measures on the spread of HIV and other sexually transmitted diseases (STDs) by reducing the uncertainty in assessing the impact of intervention strategies such as random screening and contact tracing. Even though contact tracing is one of the most effective methods used for controlling treatable STDs, it is still a controversial strategy for controlling HIV because of cost and confidentiality issues. To help estimate the effectiveness of these control measures, we formulate two models with random screening and contact tracing based on the differential infectivity (DI) model and the staged-progression (SP) model. We derive formulas for the reproductive numbers and the endemic equilibria and compare the impact that random screening and contact tracing have in slowing the epidemic in the two models. In the DI model the infected population is divided into groups according to their infectiousness, and HIV is largely spread by a small, highly infectious, group of superspreaders. In this model contact tracing is an effective approach to identifying the superspreaders and has a large effect in slowing the epidemic. In the SP model every infected individual goes through a series of infection stages and the virus is primarily spread by individuals in an initial highly infectious stage or in the late stages of the disease. In this model random screening is more effective than for the DI model, and contact tracing is less effective. Thus the effectiveness of the intervention strategy strongly depends on the underlying etiology of the disease transmission.     

Epidemic Contact Tracing via Communication Traces

Traditional contact tracing relies on knowledge of the interpersonal network of physical interactions, where contagious outbreaks propagate. However, due to privacy constraints and noisy data assimilation, this network is generally difficult to reconstruct accurately. Communication traces obtained by mobile phones are known to be good proxies for the physical interaction network, and they may provide a valuable tool for contact tracing. Motivated by this assumption, we propose a model for contact tracing, where an infection is spreading in the physical interpersonal network, which can never be fully recovered; and contact tracing is occurring in a communication network which acts as a proxy for the first. We apply this dual model to a dataset covering 72 students over a 9 month period, for which both the physical interactions as well as the mobile communication traces are known. Our results suggest that a wide range of contact tracing strategies may significantly reduce the final size of the epidemic, by mainly affecting its peak of incidence. However, we find that for low overlap between the face-to-face and communication interaction network, contact tracing is only efficient at the beginning of the outbreak, due to rapidly increasing costs as the epidemic evolves. Overall, contact tracing via mobile phone communication traces may be a viable option to arrest contagious outbreaks.     

Dynamics of Epidemiological Models

We study the SIS and SIRI epidemic models discussing different approaches to compute the thresholds that determine the appearance of an epidemic disease. The stochastic SIS model is a well known mathematical model, studied in several contexts. Here, we present recursively derivations of the dynamic equations for all the moments and we derive the stationary states of the state variables using the moment closure method. We observe that the steady states give a good approximation of the quasi-stationary states of the SIS model. We present the relation between the SIS stochastic model and the contact process introducing creation and annihilation operators. For the spatial stochastic epidemic reinfection model SIRI, where susceptibles S can become infected I, then recover and remain only partial immune against reinfection R, we present the phase transition lines using the mean field and the pair approximation for the moments. We use a scaling argument that allow us to determine analytically an explicit formula for the phase transition lines in pair approximation.     

Network-based analysis of stochastic SIR epidemic models with random and proportionate mixing

In this paper, we outline the theory of epidemic percolation networks and their use in the analysis of stochastic susceptible-infectious-removed (SIR) epidemic models on undirected contact networks. We then show how the same theory can be used to analyze stochastic SIR models with random and proportionate mixing. The epidemic percolation networks for these models are purely directed because undirected edges disappear in the limit of a large population. In a series of simulations, we show that epidemic percolation networks accurately predict the mean outbreak size and probability and final size of an epidemic for a variety of epidemic models in homogeneous and heterogeneous populations. Finally, we show that epidemic percolation networks can be used to re-derive classical results from several different areas of infectious disease epidemiology. In an Appendix, we show that an epidemic percolation network can be defined for any time-homogeneous stochastic SIR model in a closed population and prove that the distribution of outbreak sizes given the infection of any given node in the SIR model is identical to the distribution of its out-component sizes in the corresponding probability space of epidemic percolation networks. We conclude that the theory of percolation on semi-directed networks provides a very general framework for the analysis of stochastic SIR models in closed populations.     

Three-stage stochastic epidemic model: an application to AIDS.

A three-stage stochastic epidemic model extending the so-called classical epidemic process to one that includes time-dependent transition probabilities is described, and a solution to the appropriate set of forward differential-difference equations is given. When an individual can move from being a susceptible to one infected with the HIV virus to one diagnosed as having AIDS, we can use this general model to describe an AIDS epidemic process. We obtain expressions for the mean and variance of the number of AIDS cases for some special cases. By comparing these with actual data, it is suggested that, for some categories of cases (in particular, children), this model might be a plausible model to describe the underlying mechanism of the AIDS epidemic.     

An assessment of preferential attachment as a mechanism for human sexual network formation

Recent research into the properties of human sexual-contact networks has suggested that the degree distribution of the contact graph exhibits power-law scaling. One notable property of this power-law scaling is that the epidemic threshold for the population disappears when the scaling exponent rho is in the range 2 < rho < or = 3. This property is of fundamental significance for the control of sexually transmitted diseases (STDs) such as HIV/AIDS since it implies that an STD can persist regardless of its transmissibility. A stochastic process, known as preferential attachment, that yields one form of power-law scaling has been suggested to underlie the scaling of sexual degree distributions. The limiting distribution of this preferential attachment process is the Yule distribution, which we fit using maximum likelihood to local network data from samples of three populations: (i) the Rakai district, Uganda; (ii) Sweden; and (iii) the USA. For all local networks but one, our interval estimates of the scaling parameters are in the range where epidemic thresholds exist. The estimate of the exponent for male networks in the USA is close to 3, but the preferential attachment model is a very poor fit to these data. We conclude that the epidemic thresholds implied by this model exist in both single-sex and two-sex epidemic model formulations. A strong conclusion that we derive from these results is that public health interventions aimed at reducing the transmissibility of STD pathogens, such as implementing condom use or high-activity anti-retroviral therapy, have the potential to bring a population below the epidemic transition, even in populations exhibiting large degrees of behavioural heterogeneity.     

The relationship between real-time and discrete-generation models of epidemic spread

Many important results in stochastic epidemic modelling are based on the Reed-Frost model or on other similar models that are characterised by unrealistic temporal dynamics. Nevertheless, they can be extended to many other more realistic models thanks to an argument first provided by Ludwig [Final size distributions for epidemics, Math. Biosci. 23 (1975) 33-46], that states that, for a disease leading to permanent immunity after recovery, under suitable conditions, a continuous-time infectious process has the same final size distribution as another more tractable discrete-generation contact process; in other words, the temporal dynamics of the epidemic can be neglected without affecting the final size distribution. Despite the importance of such an argument, its presence behind many results is often not clearly stated or hidden in references to previous results. In this paper, we reanalyse Ludwig’s result, highlighting some of the conditions under which it does not hold and providing a general framework to examine the differences between the continuous-time and the discrete-generation process.     

Effects of dispersal mechanisms on spatio-temporal development of epidemics

The nature of pathogen transport mechanisms strongly determines the spatial pattern of disease and, through this, the dynamics and persistence of epidemics in plant populations. Up to recently, the range of possible mechanisms or interactions assumed by epidemic models has been limited: either independent of the location of individuals (mean-field models) or restricted to local contacts (between nearest neighbours or decaying exponentially with distance). Real dispersal processes are likely to lie between these two extremes, and many are well described by long-tailed contact kernels such as power laws. We investigate the effect of different spatial dispersal mechanisms on the spatio-temporal spread of disease epidemics by simulating a stochastic Susceptible-infective model motivated by previous data analyses. Both long-term stationary behaviour (in the presence of a control or recovery process) and transient behaviour (which varies widely within and between epidemics) are examined. We demonstrate the relationship between epidemic size and disease pattern (characterized by spatial autocorrelation), and its dependence on dispersal and infectivity parameters. Special attention is given to boundary effects, which can decrease disease levels significantly relative to standard, periodic geometries in cases of long-distance dispersal. We propose and test a definition of transient duration which captures the dependence of transients on dispersal mechanisms. We outline an analytical approach that represents the behaviour of the spatially-explicit model, and use it to prove that the epidemic size is predicted exactly by the mean-field model (in the limit of an infinite system) when dispersal is sufficiently long ranged (i.e. when the power-law exponent a相似文献   

Epidemic management and control through risk-dependent individual contact interventions

Testing, contact tracing, and isolation (TTI) is an epidemic management and control approach that is difficult to implement at scale because it relies on manual tracing of contacts. Exposure notification apps have been developed to digitally scale up TTI by harnessing contact data obtained from mobile devices; however, exposure notification apps provide users only with limited binary information when they have been directly exposed to a known infection source. Here we demonstrate a scalable improvement to TTI and exposure notification apps that uses data assimilation (DA) on a contact network. Network DA exploits diverse sources of health data together with the proximity data from mobile devices that exposure notification apps rely upon. It provides users with continuously assessed individual risks of exposure and infection, which can form the basis for targeting individual contact interventions. Simulations of the early COVID-19 epidemic in New York City are used to establish proof-of-concept. In the simulations, network DA identifies up to a factor 2 more infections than contact tracing when both harness the same contact data and diagnostic test data. This remains true even when only a relatively small fraction of the population uses network DA. When a sufficiently large fraction of the population (≳ 75%) uses network DA and complies with individual contact interventions, targeting contact interventions with network DA reduces deaths by up to a factor 4 relative to TTI. Network DA can be implemented by expanding the computational backend of existing exposure notification apps, thus greatly enhancing their capabilities. Implemented at scale, it has the potential to precisely and effectively control future epidemics while minimizing economic disruption.     

Interval estimates for epidemic thresholds in two-sex network models

Epidemic thresholds in network models of heterogeneous populations characterized by highly right-skewed contact distributions can be very small. When the population is above the threshold, an epidemic is inevitable and conventional control measures to reduce the transmissibility of a pathogen will fail to eradicate it. We consider a two-sex network model for a sexually transmitted disease which assumes random mixing conditional on the degree distribution. We derive expressions for the basic reproductive number (R(0)) for one and heterogeneous two-population in terms of characteristics of the degree distributions and transmissibility. We calculate interval estimates for the epidemic thresholds for stochastic process models in three human populations based on representative surveys of sexual behavior (Uganda, Sweden, USA). For Uganda and Sweden, the epidemic threshold is greater than zero with high confidence. For the USA, the interval includes zero. We discuss the implications of these findings along with the limitations of epidemic models which assume random mixing.     

Contact tracing and disease control

Contact tracing, followed by treatment or isolation, is a key control measure in the battle against infectious diseases. It is an extreme form of locally targeted control, and as such has the potential to be highly efficient when dealing with low numbers of cases. For this reason it is frequently used to combat sexually transmitted diseases and new invading pathogens. Accurate modelling of contact tracing requires explicit information about the disease-transmission pathways from each individual, and hence the network of contacts. Here, pairwise-approximation methods and full stochastic simulations are used to investigate the utility of contact tracing. A simple relationship is found between the efficiency of contact tracing necessary for eradication and the basic reproductive ratio of the disease. This holds for a wide variety of realistic situations including heterogeneous networks containing core-groups or super-spreaders, and asymptomatic individuals. Clustering (transitivity) within the transmission network is found to destroy the relationship, requiring lower efficiency than predicted.     

Numerical integration of the master equation in some models of stochastic epidemiology

The processes by which disease spreads in a population of individuals are inherently stochastic. The master equation has proven to be a useful tool for modeling such processes. Unfortunately, solving the master equation analytically is possible only in limited cases (e.g., when the model is linear), and thus numerical procedures or approximation methods must be employed. Available approximation methods, such as the system size expansion method of van Kampen, may fail to provide reliable solutions, whereas current numerical approaches can induce appreciable computational cost. In this paper, we propose a new numerical technique for solving the master equation. Our method is based on a more informative stochastic process than the population process commonly used in the literature. By exploiting the structure of the master equation governing this process, we develop a novel technique for calculating the exact solution of the master equation--up to a desired precision--in certain models of stochastic epidemiology. We demonstrate the potential of our method by solving the master equation associated with the stochastic SIR epidemic model. MATLAB software that implements the methods discussed in this paper is freely available as Supporting Information S1.     

Pair-level approximations to the spatio-temporal dynamics of epidemics on asymmetric contact networks

The process of infection during an epidemic can be envisaged as being transmitted via a network of routes represented by a contact network. Most differential equation models of epidemics are mean-field models. These contain none of the underlying spatial structure of the contact network. By extending the mean-field models to pair-level, some of the spatial structure can be contained in the model. Some networks of transmission such as river or transportation networks are clearly asymmetric, whereas others such as airborne infection can be regarded as symmetric. Pair-level models have been developed to describe symmetric contact networks. Here we report on work to develop a pair-level model that is also applicable to asymmetric contact networks. The procedure for closing the model at the level of pairs is discussed in detail. The model is compared against stochastic simulations of epidemics on asymmetric contact networks and against the predictions of the symmetric model on the same networks. DEFRA funded project FC1153     

On a simple epidemic model with a heterogeneous infective population

This paper is concerned with a generalization of the simple epidemic model in which the infective population is partitioned intom classes, each of specific infectiousness. Attention is restricted, however, to the case where all the meeting rates between two individuals are equal to each other. Both deterministic and stochastic versions are examined. In either case the development in time of the epidemic process is investigated by exploiting a connection with the standard simple epidemic model. Finally, it is shown that the technique used also applies to a similar model for the spread of information.     

Stochastic modeling of nonlinear epidemiology

The objectives of this paper to analyse, model and simulate the spread of an infectious disease by resorting to modern stochastic algorithms. The approach renders it possible to circumvent the simplifying assumption of linearity imposed in the majority of the past works on stochastic analysis of epidemic processes. Infectious diseases are often transmitted through contacts of those infected with those susceptible; hence the processes are inherently nonlinear. According to the classical model of Kermack and McKendrick, or the SIR model, three classes of populations are involved in two types of processes: conversion of susceptibles (S) to infectives (I) and conversion of infectives to removed (R). The master equations of the SIR process have been formulated through the probabilistic population balance around a particular state by considering the mutually exclusive events. The efficacy of the present methodology is mainly attributable to its ability to derive the governing equations for the means, variances and covariance of the random variables by the method of system-size expansion of the nonlinear master equations. Solving these equations simultaneously along with rates associated influenza epidemic data yields information concerning not only the means of the three populations but also the minimal uncertainties of these populations inherent in the epidemic. The stochastic pathways of the three different classes of populations during an epidemic, i.e. their means and the fluctuations around these means, have also been numerically simulated independently by the algorithm derived from the master equations, as well as by an event-driven Monte Carlo algorithm. The master equation and Monte Carlo algorithms have given rise to the identical results.     

Predicting Unobserved Exposures from Seasonal Epidemic Data

We consider a stochastic Susceptible-Exposed-Infected-Recovered (SEIR) epidemiological model with a contact rate that fluctuates seasonally. Through the use of a nonlinear, stochastic projection, we are able to analytically determine the lower dimensional manifold on which the deterministic and stochastic dynamics correctly interact. Our method produces a low dimensional stochastic model that captures the same timing of disease outbreak and the same amplitude and phase of recurrent behavior seen in the high dimensional model. Given seasonal epidemic data consisting of the number of infectious individuals, our method enables a data-based model prediction of the number of unobserved exposed individuals over very long times.     

Unravelling transmission trees of infectious diseases by combining genetic and epidemiological data

Knowledge on the transmission tree of an epidemic can provide valuable insights into disease dynamics. The transmission tree can be reconstructed by analysing either detailed epidemiological data (e.g. contact tracing) or, if sufficient genetic diversity accumulates over the course of the epidemic, genetic data of the pathogen. We present a likelihood-based framework to integrate these two data types, estimating probabilities of infection by taking weighted averages over the set of possible transmission trees. We test the approach by applying it to temporal, geographical and genetic data on the 241 poultry farms infected in an epidemic of avian influenza A (H7N7) in The Netherlands in 2003. We show that the combined approach estimates the transmission tree with higher correctness and resolution than analyses based on genetic or epidemiological data alone. Furthermore, the estimated tree reveals the relative infectiousness of farms of different types and sizes.